Background: Musculoskeletal complications are common yet under-recognized consequences of stroke, contributing to functional limitation and reduced quality of life. Limited evidence exists from Bangladesh regarding post-stroke musculoskeletal sequelae and associated risk factors.

Methods: A hospital-based cross-sectional study was conducted among 105 adult stroke survivors (falling short of the calculated target of 143) receiving care in a tertiary hospital in Dhaka, Bangladesh. Data were collected using a semi-structured questionnaire and clinical assessment checklist, including the Numerical Pain Rating Scale and Oxford muscle strength grading. Associations between musculoskeletal complications and demographic and clinical factors were analysed using descriptive statistics and chi-square tests.

Results: Most of the respondents were elderly, with 64.8% aged 72-90 years; the majority were male (78.1%), and 94.3% reported at least one musculoskeletal complication. Muscle wasting (73.3%) and musculoskeletal pain (63.8%) were most prevalent. Joint stiffness, shoulder subluxation, foot drop, and spasticity were also observed. Musculoskeletal complications were significantly associated with age, marital status, and onset timing (all p < 0.001). Most participants relied on wheelchairs (68.6%), and 80% participated in some form of rehabilitation programme.

Conclusion: Musculoskeletal complications are highly prevalent among stroke survivors in Dhaka and significantly contribute to post-stroke disability. Early identification, timely physiotherapy, and structured caregiver education are essential to mitigate these complications. Strengthening rehabilitation services within routine stroke care can improve functional outcomes and quality of life.